{"title":"在医疗保健中允许良心反对的结果主义案例。","authors":"Steve Clarke","doi":"10.1136/jme-2025-111262","DOIUrl":null,"url":null,"abstract":"<p><p>Prominent consequentialists who write about conscientious objection (CO) in healthcare, Julian Savulescu and Udo Schüklenk, both argue for the 'incompatibility thesis'-the view that healthcare professionals ought never to be entitled to exercise a CO to absolve themselves of the responsibility to perform professional duties. I argue, <i>contra</i> Savulescu and Schüklenk, that consequentialists should advocate for a compromise position under which healthcare professionals are entitled to conscientiously object to providing some services under some circumstances. The compromise advocated differs dramatically from the most prominent compromise position in the academic literature on CO in healthcare, Brock's 'conventional compromise'. The conventional compromise relies on referral, and I show that this is a problematic tool for consequentialists to rely on. I argue that the best approach to managing CO, from a consequentialist point of view, is to set up a system of region-based registers of available healthcare professionals who lack COs to procedures for which COs are permitted. Patients and healthcare professionals in the given region would be able to access-and be encouraged to consult-the register for their region before receiving any form of healthcare for which COs are permitted, thereby eliminating the need for referral in most circumstances.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A consequentialist case for permitting conscientious objection in healthcare.\",\"authors\":\"Steve Clarke\",\"doi\":\"10.1136/jme-2025-111262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Prominent consequentialists who write about conscientious objection (CO) in healthcare, Julian Savulescu and Udo Schüklenk, both argue for the 'incompatibility thesis'-the view that healthcare professionals ought never to be entitled to exercise a CO to absolve themselves of the responsibility to perform professional duties. I argue, <i>contra</i> Savulescu and Schüklenk, that consequentialists should advocate for a compromise position under which healthcare professionals are entitled to conscientiously object to providing some services under some circumstances. The compromise advocated differs dramatically from the most prominent compromise position in the academic literature on CO in healthcare, Brock's 'conventional compromise'. The conventional compromise relies on referral, and I show that this is a problematic tool for consequentialists to rely on. I argue that the best approach to managing CO, from a consequentialist point of view, is to set up a system of region-based registers of available healthcare professionals who lack COs to procedures for which COs are permitted. Patients and healthcare professionals in the given region would be able to access-and be encouraged to consult-the register for their region before receiving any form of healthcare for which COs are permitted, thereby eliminating the need for referral in most circumstances.</p>\",\"PeriodicalId\":16317,\"journal\":{\"name\":\"Journal of Medical Ethics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Ethics\",\"FirstCategoryId\":\"98\",\"ListUrlMain\":\"https://doi.org/10.1136/jme-2025-111262\",\"RegionNum\":2,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Ethics","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1136/jme-2025-111262","RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ETHICS","Score":null,"Total":0}
A consequentialist case for permitting conscientious objection in healthcare.
Prominent consequentialists who write about conscientious objection (CO) in healthcare, Julian Savulescu and Udo Schüklenk, both argue for the 'incompatibility thesis'-the view that healthcare professionals ought never to be entitled to exercise a CO to absolve themselves of the responsibility to perform professional duties. I argue, contra Savulescu and Schüklenk, that consequentialists should advocate for a compromise position under which healthcare professionals are entitled to conscientiously object to providing some services under some circumstances. The compromise advocated differs dramatically from the most prominent compromise position in the academic literature on CO in healthcare, Brock's 'conventional compromise'. The conventional compromise relies on referral, and I show that this is a problematic tool for consequentialists to rely on. I argue that the best approach to managing CO, from a consequentialist point of view, is to set up a system of region-based registers of available healthcare professionals who lack COs to procedures for which COs are permitted. Patients and healthcare professionals in the given region would be able to access-and be encouraged to consult-the register for their region before receiving any form of healthcare for which COs are permitted, thereby eliminating the need for referral in most circumstances.
期刊介绍:
Journal of Medical Ethics is a leading international journal that reflects the whole field of medical ethics. The journal seeks to promote ethical reflection and conduct in scientific research and medical practice. It features articles on various ethical aspects of health care relevant to health care professionals, members of clinical ethics committees, medical ethics professionals, researchers and bioscientists, policy makers and patients.
Subscribers to the Journal of Medical Ethics also receive Medical Humanities journal at no extra cost.
JME is the official journal of the Institute of Medical Ethics.